Paronychia
Paronychia is an inflammation of the skin bordering a fingernail or toenail. This inflammation can be classified as acute or chronic, depending on your symptoms, the cause of the inflammation, and how long you have had it.
Acute paronychia
Acute paronychia is usually a painful condition that develops over one to 2 days. It is usually associated with problems which involve trauma to the skin, such as a hang-nail, ingrown nail or nail biting.
Acute paronychia is usually caused by a bacterial infection, and the bacteria called Staphylococcus aureus is the most common cause.
Acute paronychia may be treated by bathing the affected finger or toe in warm, salty water 2 or 3 times a day. If there is a collection of pus, your doctor may drain the pus by puncturing the overlying skin. Rarely, a portion of the nail might also need to be removed. Acute paronychia will occasionally need to be treated with antibiotics.
Chronic paronychia
Chronic paronychia differs from acute paronychia in that it is usually not painful and develops over a longer time period. It usually reflects ongoing exposure to an irritant, and commonly occurs in people who spend a lot of time with their hands in water, such as chefs, cleaners and hairdressers. Children who suck their fingers are also at risk of developing chronic paronychia.
Corticosteroid creams are helpful in treating chronic paronychia. Chronic paronychia is often complicated by a fungal infection, which can be treated with antifungal preparations that are applied directly to the affected area. The inflamed area can also become infected with bacteria, which may or may not require antibiotic treatment.
The mainstay of treatment for chronic paronychia is avoiding the irritant that is causing the inflammation. In most cases, this means keeping your hands dry and avoiding wet work wherever possible. Other irritants to be avoided include detergents, soap, grease and solvents. People with chronic paronychia should also avoid nail biting, manicuring or aggressively cleaning the cuticles.
If your toes are affected, you should make sure that the irritation is not the result of poorly fitting shoes.
People at risk of paronychia complications
People with certain medical conditions are more prone to acute and chronic paronychia, and are more likely to have complications from the inflammation. People who are more at risk include those with:
- diabetes;
- poor blood circulation to their extremities; or
- a suppressed immune system (e.g. people undergoing chemotherapy or people with AIDS).
If you have a condition that puts you at increased risk and you develop symptoms of paronychia, it’s important to seek medical help early so that complications can be avoided.
Last Reviewed: 24 April 2008
